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NDT Advance Access published online on February 3, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl845
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Elevation of plasma D-dimer is closely associated with venous thrombosis produced by double-lumen catheter in pre-dialysis patients

Yoshihiko Kanno, Kazuhiro Kobayashi, Hiroshi Takane, Hiroshi Arima, Naofumi Ikeda, Junko Shoda and Hiromichi Suzuki

Department of Nephrology, School of Medicine, Faculty of Medicine, Saitama Medical University

Correspondence and offprint requests to: Prof. Hiromichi Suzuki, Department of Nephrology, School of Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo Moroyama, Iruma, Saitama, 350-0495 Japan. Email: iromichi{at}saitama-med.ac.jp



  Abstract

Background. A double-lumen catheter (DLC) is used as a temporary blood access in emergency haemodialysis and continuous haemodialysis. There are various reports concerning thrombosis related to use of DLC and other catheters. The objective of this study is to assess the incidence of venous thrombosis when using DLC in patients undergoing blood purification.

Method. Forty-eight Japanese patients, hospitalized in the Saitama Medical University hospital from December 2004 to April 2005, who had DLC insertion as a temporary blood access for blood purification. The existence of a thrombus was determined using ultrasonography, before catheter insertion, and every 2 days after insertion up to 3 weeks. At the time of DLC insertion, general blood tests including plasma D-dimer, and serum C-reactive protein (CRP) were performed. When DLC was removed, plasma D-dimer and serum CRP were measured.

Results. In 30 of 48 (62.5%) patients with DLC insertion as a temporary blood access for haemodialysis, venous thrombi with diameters >1.1 mm were detected by venous ultrasonography. No predictive factors were recognized except an increase in plasma D-dimer that was significantly higher in the patients with venous thrombus. The changes in plasma D-dimer were 3.54 (SE 0.8) µg/dl in patient with thrombus, and 0.29 (0.30) µg/dl in patient without thrombus (P = 0.004).

Conclusions. The study suggests that changes in plasma D-dimer after the insertion of the catheter may be used to predict thrombus formation and is more accurate than baseline measurements, and easier than other new markers.

Keywords: D-dimer; double-lumen catheter (DLC); haemodialysis; pulmonary embolism; thrombosis


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